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COVID-19 Knowledge and Prevention Behaviors in Rural Zambia: A Qualitative Application of the Information-Motivation-Behavioral Skills Model

In early 2020, the Zambian Ministry of Health instituted prevention guidelines to limit spread of COVID-19. We assessed community knowledge, motivations, behavioral skills, and perceived community adherence to prevention behaviors (i.e., hand hygiene, mask wearing, social distancing, and limiting ga...

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Autores principales: Kaiser, Jeanette L., Hamer, Davidson H., Juntunen, Allison, Ngoma, Thandiwe, Fink, Günther, Schueler, Jessica, Rockers, Peter C., Biemba, Godfrey, Scott, Nancy A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The American Society of Tropical Medicine and Hygiene 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10323997/
https://www.ncbi.nlm.nih.gov/pubmed/37253445
http://dx.doi.org/10.4269/ajtmh.22-0604
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author Kaiser, Jeanette L.
Hamer, Davidson H.
Juntunen, Allison
Ngoma, Thandiwe
Fink, Günther
Schueler, Jessica
Rockers, Peter C.
Biemba, Godfrey
Scott, Nancy A.
author_facet Kaiser, Jeanette L.
Hamer, Davidson H.
Juntunen, Allison
Ngoma, Thandiwe
Fink, Günther
Schueler, Jessica
Rockers, Peter C.
Biemba, Godfrey
Scott, Nancy A.
author_sort Kaiser, Jeanette L.
collection PubMed
description In early 2020, the Zambian Ministry of Health instituted prevention guidelines to limit spread of COVID-19. We assessed community knowledge, motivations, behavioral skills, and perceived community adherence to prevention behaviors (i.e., hand hygiene, mask wearing, social distancing, and limiting gatherings). Within a cluster-randomized controlled trial in four rural districts, in November 2020 and May 2021, we conducted in-depth interviews with health center staff (N = 19) and community-based volunteers (N = 34) and focus group discussions with community members (N = 281). A content analysis was conducted in Nvivo v12. Data were interpreted using the Information-Motivation-Behavioral Skills Model. Generally, respondents showed good knowledge of COVID-19 symptoms, spread, and high-risk activities, with some gaps. Prevention behavior performance was driven by personal and social factors. Respondents described institutional settings (e.g., clinics and church) having higher levels of perceived adherence due to stronger enforcement measures and clear leadership. Conversely, informal community settings (e.g., weddings, funerals, football matches) lacked similar social and leadership expectations for adherence and had lower perceived levels of adherence. These settings often involved higher emotions (excitement or grief), and many involved alcohol use, resulting in community members “forgetting” guidelines. Doubt about disease existence or need for precautions persisted among some community members and drove non-adherence more generally. Although COVID-19 information successfully penetrated these very remote rural communities, more targeted messaging may address persistent COVID-19 doubt and misinformation. Engaging local leaders in religious, civic, and traditional leadership positions could improve community behaviors without adding additional monitoring duties on an already overburdened, resource-limited health system.
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spelling pubmed-103239972023-07-06 COVID-19 Knowledge and Prevention Behaviors in Rural Zambia: A Qualitative Application of the Information-Motivation-Behavioral Skills Model Kaiser, Jeanette L. Hamer, Davidson H. Juntunen, Allison Ngoma, Thandiwe Fink, Günther Schueler, Jessica Rockers, Peter C. Biemba, Godfrey Scott, Nancy A. Am J Trop Med Hyg Research Article In early 2020, the Zambian Ministry of Health instituted prevention guidelines to limit spread of COVID-19. We assessed community knowledge, motivations, behavioral skills, and perceived community adherence to prevention behaviors (i.e., hand hygiene, mask wearing, social distancing, and limiting gatherings). Within a cluster-randomized controlled trial in four rural districts, in November 2020 and May 2021, we conducted in-depth interviews with health center staff (N = 19) and community-based volunteers (N = 34) and focus group discussions with community members (N = 281). A content analysis was conducted in Nvivo v12. Data were interpreted using the Information-Motivation-Behavioral Skills Model. Generally, respondents showed good knowledge of COVID-19 symptoms, spread, and high-risk activities, with some gaps. Prevention behavior performance was driven by personal and social factors. Respondents described institutional settings (e.g., clinics and church) having higher levels of perceived adherence due to stronger enforcement measures and clear leadership. Conversely, informal community settings (e.g., weddings, funerals, football matches) lacked similar social and leadership expectations for adherence and had lower perceived levels of adherence. These settings often involved higher emotions (excitement or grief), and many involved alcohol use, resulting in community members “forgetting” guidelines. Doubt about disease existence or need for precautions persisted among some community members and drove non-adherence more generally. Although COVID-19 information successfully penetrated these very remote rural communities, more targeted messaging may address persistent COVID-19 doubt and misinformation. Engaging local leaders in religious, civic, and traditional leadership positions could improve community behaviors without adding additional monitoring duties on an already overburdened, resource-limited health system. The American Society of Tropical Medicine and Hygiene 2023-05-30 2023-07 /pmc/articles/PMC10323997/ /pubmed/37253445 http://dx.doi.org/10.4269/ajtmh.22-0604 Text en © The author(s) https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution (CC-BY) License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Kaiser, Jeanette L.
Hamer, Davidson H.
Juntunen, Allison
Ngoma, Thandiwe
Fink, Günther
Schueler, Jessica
Rockers, Peter C.
Biemba, Godfrey
Scott, Nancy A.
COVID-19 Knowledge and Prevention Behaviors in Rural Zambia: A Qualitative Application of the Information-Motivation-Behavioral Skills Model
title COVID-19 Knowledge and Prevention Behaviors in Rural Zambia: A Qualitative Application of the Information-Motivation-Behavioral Skills Model
title_full COVID-19 Knowledge and Prevention Behaviors in Rural Zambia: A Qualitative Application of the Information-Motivation-Behavioral Skills Model
title_fullStr COVID-19 Knowledge and Prevention Behaviors in Rural Zambia: A Qualitative Application of the Information-Motivation-Behavioral Skills Model
title_full_unstemmed COVID-19 Knowledge and Prevention Behaviors in Rural Zambia: A Qualitative Application of the Information-Motivation-Behavioral Skills Model
title_short COVID-19 Knowledge and Prevention Behaviors in Rural Zambia: A Qualitative Application of the Information-Motivation-Behavioral Skills Model
title_sort covid-19 knowledge and prevention behaviors in rural zambia: a qualitative application of the information-motivation-behavioral skills model
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10323997/
https://www.ncbi.nlm.nih.gov/pubmed/37253445
http://dx.doi.org/10.4269/ajtmh.22-0604
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